Nursing Elites

1. A client with type 2 Diabetes Mellitus is starting Repaglinide. Which statement by the client indicates understanding of the administration of this medication?

• A. I'll take this medicine with my meals.
• B. I'll take this medicine 30 minutes before I eat.
• C. I'll take this medicine just before I go to bed.
• D. I'll take this medicine as soon as I wake up in the morning.

Correct answer: B

Rationale: The correct answer is B. Repaglinide causes a rapid, short-lived release of insulin. To ensure the insulin is available when food is digested, the client should take this medication 30 minutes before each meal. This timing aligns the medication with the expected postprandial rise in blood glucose levels, optimizing its effectiveness in controlling blood sugar levels. Choices A, C, and D are incorrect because taking Repaglinide with meals, just before bed, or as soon as waking up does not align with the medication's mechanism of action and timing needed for optimal effectiveness.

2. A client who received Prochlorperazine 4 hours ago reports spasms of his face. The nurse should anticipate a prescription for which of the following medications?

• A. Fomepizole
• B. Naloxone
• C. Phytonadione
• D. Diphenhydramine

Correct answer: D

Rationale: An adverse effect of prochlorperazine is acute dystonia, which is evidenced by spasms of the muscles in the face, neck, and tongue. Diphenhydramine is used to suppress extrapyramidal effects of prochlorperazine, making it the most appropriate choice to address the client's spasms. Fomepizole is used in methanol or ethylene glycol poisoning, not for acute dystonia. Naloxone is an opioid antagonist used for opioid overdose, not for acute dystonia. Phytonadione is vitamin K, used for the reversal of warfarin, not for acute dystonia.

3. What is the primary use of lithium?

• A. Lower blood glucose
• B. Slow the heart rate
• C. Stabilize mood
• D. Heal ulcers

Correct answer: C

Rationale: The correct answer is C: Stabilize mood. Lithium is primarily used to stabilize mood, especially in conditions like bipolar disorder. It helps in reducing the frequency and severity of manic episodes, making it an essential medication for mood stabilization. Choices A, B, and D are incorrect as lithium is not used to lower blood glucose, slow the heart rate, or heal ulcers.

4. A healthcare professional is preparing to administer vancomycin 1 g by intermittent IV bolus. Available is vancomycin 1 g in 100 mL of dextrose 5% in water (D5W) to infuse over 45 min. The drop factor of the manual IV tubing is 10 gtt/mL. How many gtt/min should the healthcare professional adjust the manual IV infusion to deliver?

• A. 22 gtt/min
• B. 24 gtt/min
• C. 20 gtt/min
• D. 18 gtt/min

Correct answer: A

Rationale: To determine the flow rate in drops per minute (gtt/min), you can use the formula: (Volume in mL x Drop factor) / Time in minutes = Flow rate in gtt/min. In this case, it would be (100 mL x 10 gtt/mL) / 45 min = 22 gtt/min. Therefore, the healthcare professional should adjust the manual IV infusion to deliver 22 gtt/min. Choice B, 24 gtt/min, is incorrect as it results from a miscalculation. Choices C and D, 20 gtt/min and 18 gtt/min respectively, are also incorrect calculations based on the given parameters.

5. A client with Depression has a new prescription for Venlafaxine. For which of the following adverse effects should the nurse monitor this client? (Select all that apply)

• A. Cough
• B. Dizziness
• C. Decreased libido
• D. B and C

Correct answer: D

Rationale: The correct answer is D: 'B and C.' Venlafaxine, a medication used to treat depression, can lead to adverse effects like dizziness and decreased libido. It is important for the nurse to monitor the client for these potential side effects. Cough and alopecia are not typically associated with Venlafaxine. Therefore, choices A (Cough) and C (Decreased libido) are incorrect. Dizziness and decreased libido are the adverse effects that the nurse should focus on when monitoring a client on Venlafaxine treatment.

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